Individual
DR. MARY KATHERINE HAGERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
710 PACHA PKWY UNIT 3, NORTH LIBERTY, IA 52317-4824
(319) 855-7842
Mailing address
1464 SUMMERPOINT LN, FENTON, MO 63026-6958
(314) 445-8209
(314) 445-8209
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
108068
IA
225100000X
Physical Therapist
2018003458
MO
225100000X
Physical Therapist
298451
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10868
STATE PT LICENSE NUMBER
IA
Enumeration date
02/16/2018
Last updated
08/27/2021
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